CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 6, November/December 2011
AFRICA
297
Cardiovascular Topics
Prevalence of asymptomatic left ventricular
systolic dysfunction in hypertensive Nigerians:
echocardiographic study of 832 subjects
OS OGAH, RO AKINYEMI, GD ADEGBITE, OI UDOFIA, SB UDOH, JO ADESINA, OS OJO, AA ALABI,
T MAJEKODUNMI, JKL OSINFADE, RF OGUNDIPE, AO FALASE
Abstract
Background:
We sought to determine the prevalence of
echocardiographically determined left ventricular systolic
dysfunction in asymptomatic hypertensive subjects seen in
Abeokuta, Nigeria.
Methods:
Echocardiography was performed in 832 consecu-
tive hypertensive subjects referred for cardiac evaluation
over a three-year period.
Results:
Data were obtained in 832 subjects (50.1% women)
aged 56.0
±
12.7 years (men 56.9
±
13.3 years, women 55.0
±
12.0 years, range 15–88). The prevalence of left ventricular
systolic dysfunction (LVSD) was 18.1% in the study popula-
tion (mild LVSD
=
9.6%, moderate LVSD
=
3.7% and severe
LVSD
=
4.8%). In a multivariate analysis, male gender, body
mass index and LV mass were the predictors of LVSD.
Conclusion:
Significant numbers of hypertensive subjects
in this study had varying degrees of left ventricular systolic
dysfunction. Early introduction of disease-modifying drugs
in these patients, such as angiotensin converting enzyme
inhibitors or angiotensin receptor blockers may retard or
prevent the progression to overt heart failure.
Keywords:
hypertension, echocardiography, systolic dysfunc-
tion, Nigeria
Submitted 19/9/09, accepted 16/8/10
Cardiovasc J Afr
2011;
22
: 297–302
DOI: 10.5830/CVJA-2010-063
High blood pressure affects about a billion people worldwide.
1-3
It has been predicted that by 2025, more than 1.5 billion adults
will have hypertension.
1-3
In the year 2001, hypertension was esti-
mated to be responsible for 7.6 million premature deaths world-
wide (13.5% of total global mortality) and it was also responsible
for 92 million disability-adjusted life years (DALYs).
1-3
The
condition has been rightly described as the foundation of cardio-
vascular disease in sub-Saharan Africa.
4
The overall prevalence
has been put at 10 to 15% but rates as high as 30 to 32% have
been reported.
5
Hypertension and its complications are responsible for about
25% of urban hospital medical admissions in Nigeria,
6
as well as
for over 80% of cardiac clinic consultations in the country. It is
the most frequently diagnosed medical illness in elderly popula-
tions
7
and senior executives.
8
High blood pressure is also by far the commonest cause of
chronic renal failure, stroke, heart failure and sudden unexpected
death in Nigeria.
9
In Nigeria, the prevalence of asymptomatic left ventricular
systolic dysfunction (LVSD) among people with hypertension is
unknown. The aim of the study was therefore to determine the
prevalence of asymptomatic LVSD in hypertensive subjects in
Abeokuta, Nigeria.
Methods
The study was conducted at the Federal Medical Centre (FMC),
Idi-Aba and the Sacred Heart Hospital (SHH), Lantoro, both
in Abeokuta, the capital city of Ogun State in south-western
Nigeria. FMC was established in 1993 by the federal government
of Nigeria to cater for the health needs of the people of Ogun
State and its environs in south-western Nigeria. The state has a
population of about 3.2 million and a surface area of about 16
409.26 km
2
. SHH is one of the oldest hospitals in Nigeria, estab-
lished in 1897 by the German Catholic Mission.
Cardiological services commenced in the city in September
2005 and since then a registry of patients and services rendered
has been kept. A cardiologist (OSO) covers the two cardiac units,
Department of Medicine, Federal Medical Centre, Idi-Aba,
Abeokuta, Ogun State, Nigeria
OS OGAH, AIMLS, FMLS, MSc,
RO AKINYEMI, MBBS
JO ADESINA, MBBS
JKL OSINFADE, MBBS, FWACP
RF OGUNDIPE, MBBS, FMCP
Department of Medicine, Sacred Heart Hospital Lantoro,
Abeokuta, Ogun State, Nigeria
GD ADEGBITE, MD
OI UDOFIA
SB UDOH
OS OJO, MBBS
AA ALABI, MBBS
Division of Adult Congenital Heart Disease, Department
of Cardiology, Royal Brompton Hospital, London, United
Kingdom
T MAJEKODUNMI, MBBS, PhD, MRCP
Department of Medicine, University of Ibadan, Oyo State,
Nigeria
AO FALASE, MBBS, MD, FMCP, FWACP, FRCP
